Anat Cell Biol.  2016 Mar;49(1):61-67. 10.5115/acb.2016.49.1.61.

Synovial tissue morphology of the cricoarytenoid joint in the elderly: a histological comparison with the cricothyroid joint

• Katsumura
• Yamamoto M
• Kitamura K
• Kasahara M
• Katori Y
• Abe SI

• KMID: 2308932
• DOI: http://doi.org/10.5115/acb.2016.49.1.61

Abstract

We compared the age-related morphology of the cricothyroid (CT) joint with that of the cricoarytenoid (CA) joint using 18 specimens from elderly cadavers in terms of their elastic fiber contents as well as the cells composing the joint capsule and synovial tissues. In contrast to an almost flat-flat interface in the CT joint, the CA joint was similar to a saddle joint. The CA joint capsule was thin and contained few elastic fibers, and in contrast to the CT joint, external fibrous tissues were not exposed to the joint cavity, there being no injury to the CA joint capsule. The lateral and posterior aspects of the CA joint were covered by the lateral and posterior CA muscles, respectively, and the fascia of the latter muscle was sometimes thick with abundant elastic fibers. However, due to possible muscle degeneration, loose connective tissue was often interposed between the fascia and the capsule. The medial and anterior aspects of the CA joint faced loose tissue that was continuous with the laryngeal submucosal tissue. Therefore, in contrast to the CT joint, a definite supporting ligament was usually absent in the CA joint. Synovial folds were always seen in the CA joint, comprising a short triangular mass on the posterior side and long laminar folds on the anterior side. The synovial folds usually contained multiple capillaries and a few CD68-positive macrophages. High congruity of the CA joint surfaces as well as strong muscle support to the arytenoid cartilage appeared to provide the specific synovial morphology.

Keyword

Cricoarytenoid joint; Elastic tissue; Synovial fold; Morphology

MeSH Terms

Aged*
Arytenoid Cartilage
Cadaver
Capillaries
Connective Tissue
Elastic Tissue
Fascia
Humans
Joint Capsule
Joints*
Ligaments
Macrophages
Muscles

Figure

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  Fig. 1 Elastic fiber-rich fascia attaching to the posterior aspect of the joint capsule. Sagittal sections of a specimen from an 81-year-old man. All panels show near sections. (A) The left-hand side of the panel corresponds to the anterior side of the body (elastica Masson staining). The joint cartilage is larger on the arytenoid side than on the cricoid side. Surface roughness is evident (A). The posterior cricoarytenoid muscle (PCAM) attaches to the joint, and a covering fascia (arrowheads) of the muscle contains abundant elastic fibers (black color). Synovial folds (SF) are triangular in shape on the posterior side of the joint, whereas they are beltlike on the anterior side. Panels (B) (immunohistochemistry for elastin), corresponding to the squares in panel (A), display strong elastin expression in the posterior fascial structure (arrowheads) supporting the joint. SF in panel (C) (immunohistochemistry for elastin) are shown in panels (D–I) using immunohistochemistry. (D) Multiple blood capillaries in the anterior fold (immunohistochemistry for factor VIII). (E–I) A few lymphocytes and macrophages (arrows) in the anterior fold ( immunohistochemistr y for CD79a, CD68, IgM, CD3, and CD8, respectively). AC, arytenoid cartilage; CC, cricoid cartilage. Scale bars=1 mm (A–D), 0.1 mm (E–I).

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  Fig. 2 Few elastic fibers in a fascia attached to the lateral aspect of the joint capsule. Sagittal sections of a specimen from an 89-year-old man. All panels show near sections. (A) The left-hand side of the panel corresponds to the anterior side of the body (elastica Masson staining). The lateral cricoarytenoid muscle (LCAM) is closely located to the joint. Part of the cricoid cartilage (asterisk) has been damaged during the histological procedure. Two long recesses of the joint cavity are seen on the anterior side. Panel (B) (immunohistochemistry for elastin), corresponding to the square in panel (A), displays elastin expression in a fascia (arrowheads) of the posterior cricoarytenoid muscle (PCAM). (C, D) Macrophages (arrows) in the synovial folds: they are rich in the fatty tissue on the anterior side of the joint (C), whereas they are sparse on a posterior fold (D) (immunohistochemistry for CD68). AC, arytenoid cartilage; CC, cricoid cartilage; SF, synovial fold. Scale bars=1 mm (A, B), 0.1 mm (C, D).

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  Fig. 3 No or few supportive structures along the joint capsule. Sagittal sections of a specimen from a 97-year-old woman. All panels show near sections. (A) The left-hand side of the panel corresponds to the anterior side of the body (H&E staining). The lateral cricoarytenoid muscle (LCAM) is located near the joint. Synovial folds (SF) are triangular in shape on the posterior side of the joint, whereas they are tongue-like on the anterior side. (B, F) A few macrophages on the SF (immunohistochemistry for CD68). Panels (C), (D) and (E) (immunohistochemistry for factor VIII, IgM, and CD8, respectively) exhibit few blood capillaries (C) and lymphocytes (D, E) in the posterior triangular fold. Arrows indicate macrophage. AC, arytenoid cartilage; CC, cricoid cartilage. Scale bars=1 mm (A), 0.1 mm (B–F).

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  Fig. 4 Schematic drawings of the carpometacarpal joint of the thumb and cricoarytenoid joint. Asterisk is the carpometacarpal joint of the thumb (A). Stars are the cricoarytenoid joint (B). The cricoarytenoid joint is similar to a saddle joint, such as the the carpometacarpal joint of the thumb.

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